Chapter 196: Highly Difficult Intestinal Anastomosis. To Become a Great Tree, Do Not Compete with Grass
Next, Director Jia explained while personally demonstrating the operation to separate and remove the patient's diseased intestinal segment.
Watching Director Jia complete various operations with ease, the entire separation and resection process was flawless, his movements were delicate and steady, his knife skills and techniques were extremely skillful, and his accuracy exceeded that of a robot.
This is the true master-level surgical skills.
Zhou Can stood by and watched, secretly absorbing the surgical advantages and experience and skills.
"When removing the diseased intestinal segment, we should not just pursue cleanliness, but also try to leave a longer intestinal segment for the patient. Otherwise, the patient will suffer from severe nutritional disorders after the operation."
The large intestine and small intestine are both organs that absorb nutrients in the human body.
Every section of intestine has its use.
They constitute the human body's entire nutrient absorption and excretion system.
If too much intestine is cut off, it will cause problems with the patient's nutritional absorption, and may also cause various problems such as frequent bowel movements and diarrhea.
Some doctors have read a lot of books, but in actual operations they lack post-operative predictions and only blindly pursue surgical results.
This ultimately resulted in the patient dying soon after the operation due to an inability to absorb nutrients, and the family angrily took the patient to court.
“Who will do the anastomosis of the next intestinal segment?”
After Director Jia completed the riskiest part, he handed over the rest of the surgery to his doctors.
This kind of doctor is a good doctor.
We attach great importance to the training of successors.
Just like Director Hu Kan of the Department of Cardiothoracic Surgery, he also pays attention to training successors. Doctors in the Department of Cardiothoracic Surgery all love him from the bottom of their hearts.
“I’ll do it!”
Zhou Can, this "invasive alien species", was very rude in grabbing the opportunity to practice surgery, which made the other doctors look very upset.
They were all polite and courteous, but when faced with someone who was thick-skinned and quick to act, they were no match at all.
"Anastasia is much more difficult than laparotomy. No one dares to take this job without more than ten years of surgical experience. You are so happy to grab it, but can you do it?" The deputy chief physician said to him with an unhappy face.
The other doctors also shared the same hatred and were very dissatisfied with the new doctor Zhou.
"You can let me try first. If it doesn't work, I'll ask you to help me finish it. Of course, according to the rules set by Director Jia, if I mess up, I won't ."
Zhou Can replied with a smile.
This answer also shut up the others.
From beginning to end, Zhou Can never said that he had the ability, but instead told these people, just wait and see me jump around.
If I make a mistake, I won’t be able to snatch the opportunity for surgery training from you within three months.
Now that things have come to this, who would dare to stop him?
So, Zhou Can once again took the position of chief surgeon with great dignity.
He did not rush to anastomose, but carefully examined the broken ends of the intestine.
The cut is very smooth.
Director Jia was also considerate enough to separate the intestines so that the two ends could be pulled together.
Zhou Can just needs to match it directly.
"Director Jia, can I choose end-to-end anastomosis?"
After looking at the incision, Zhou Can took the initiative to ask Director Jia for his opinion.
This is a very smart approach.
It can greatly enhance the trust of senior doctors in him.
If he grabs the opportunity to practice and starts anastomosis right away, he will be considered as being rash and eager for quick success. After the senior doctor has a bad impression of him, he will feel uncomfortable when he is assigned tasks in the future.
"End-to-end anastomosis is the most commonly used anastomosis method and is the most consistent with physiological conditions. The anastomosis method you chose is very good. Hurry up and anastomose it!"
Director Jia's words were like a reassurance to him.
Depending on the different intestinal segments, the anastomosis method chosen will also be different.
In addition to end-to-end anastomosis, side-to-side anastomosis is also commonly used.
Zhou Can used absorbable sutures to bring the two cut ends together and continuously suture the entire layer of the intestinal wall.
The outer seromuscular layer is sutured intermittently using non-absorbable sutures.
Director Jia did not just leave it alone, but provided careful guidance from the side.
Each chief physician has a different teaching method and his or her own style.
When Director Jia taught him the operation, he mostly gave pointers and did not influence Zhou Can's independent thinking, which was equivalent to supportive teaching.
Director Hu Kan teaches by analogy, and likes to patiently teach junior doctors all the surgical skills and experiences involved, as well as various situations that may be encountered.
Director Shen of the Department of Orthopedics teaches in a simple and easy-to-understand manner, with extensive citations and emphasis on theoretical explanations.
When Dr. Xu teaches, he is extremely strict, with a sharp tongue but a soft heart.
When mistakes occur during the operation, he will criticize you seriously, then clean up the mess for you, tell you where you went wrong and how to avoid it.
Zhou Can anastomosed the intestinal ends carefully and quickly.
You can see sweat dripping from his forehead.
There is definitely tension.
At the same time, this is a physical job, which involves more fatigue and sweating.
The nurse on duty wiped his sweat considerately to ensure the smooth progress of the operation.
It is not allowed for sweat to drip onto the patient's wounds.
After nearly an hour of anastomosis, Zhou Can finally successfully anastomosed the intestinal ends.
[Matching experience value +1. ]
[Congratulations on completing the colon stump anastomosis for the first time, and you will be awarded +100 experience points. ]
I successfully earned 101 surgical experience points, which feels great.
The human body has many organs. For some difficult surgical tasks, as long as it is the first attempt and successfully completed, you can get a reward of 100 experience points.
Don’t be fooled by the fact that his anastomosis skills are now at level four, and his main treatment is at a lower level.
To advance to level 5, you need 10,000 experience points.
If he could occasionally perform a challenging and difficult anastomosis, it would probably take less than three months for him to be promoted to deputy director level in anastomosis.
The reward is 100 experience points each time, which is quite a considerable reward.
Under normal circumstances, he would need to complete a hundred ordinary anastomosis operations to earn so many experience points.
"Jia Zhuquan, please help me check it out! Let me see if there are any areas where I didn't do it well. I will try to correct it next time."
He chose his words carefully.
It did not say that it must be corrected, but instead used the flexible word "strive for".
It’s not that he is not humble enough, but because some of the shortcomings in the operation cannot be changed just because you want to.
It is like when we practice calligraphy, we know that we didn’t write it well. We will pay attention to it next time, but we still can’t write it well.
This is what is often said as having good intentions but not being able to do anything.
Almost all technical movements require thousands of times of practice to get better and better.
It is impossible to spot a mistake and correct it immediately.
It is almost impossible for such a genius to exist.
At most, you will get better and better.
"Overall, the anastomosis is pretty good. There are many areas that can be improved, such as when suturing continuously, the denser the better. Also, the selection of the initial position when anastomosing the intestinal tube should be carefully considered. Taking this patient as an example, I personally think that choosing to start the anastomosis from here will reduce the difficulty of your anastomosis and the probability of leakage..."
Director Jia is of a very high level.
The defects pointed out by Zhou Can were either due to his inability to do the job or because it was his first time matching and he lacked experience.
Others are errors that occur during the matching process.
Being able to do this is almost his limit.
He noted down all the places he had not done well, and then secretly concluded that he would definitely do better the next time he performed a similar intestinal anastomosis.
In fact, if the many defects pointed out by Director Jia can be corrected, the ability to improve is not just the intestinal end anastomosis, but the entire level of anastomosis.
"Who will do the closing?"
Director Jia asked.
This time Zhou Can did not try to grab it, but quietly stepped aside.
There is a limit to what you do and a standard to what you do as a person.
It is an absolute taboo for him to take all the benefits alone.
On his first day in the Department of Digestive Surgery, he might become the "enemy" of these deputy chief physicians and attending physicians.
Sometimes, making enemies does not necessarily mean conflicts or quarrels with others, it may also mean touching other people’s interests.
The adult world is based on interests.
Zhou Can grabbed all the surgical opportunities, and the others stood by and watched stupidly. He was just a newcomer, so wasn't that just making people hate him?
"I'll do it, I'll do it!"
A resident doctor rushed to answer. Seeing his anxious look, he was afraid that Zhou Can would snatch away his practice opportunity again, which made others smile.
"Haha, it seems that Zhou Can's arrival did play a certain positive role! At least you got the chance to practice surgery, and you no longer act like ladies from wealthy families."
Director Jia was particularly happy about this.
In the past, when we asked these people who wanted a chance to have surgery, they were all hesitant and it took a long time for someone to express their opinion.
It is undeniable that the punishment he set was indeed a bit harsh, but it was for everyone's good.
If something really goes wrong, everyone will be in trouble.
The operation was concluded after more than forty minutes.
If Zhou Can was the one who closed the singing, it could have ended at least twenty minutes earlier.
The resident's suturing skills were not bad, he was just too cautious.
Every stitch is like a mouse coming out of a hole. It will never run out unless it looks carefully at the surrounding situation.
"If you need to go to the toilet, do it now. If you need to drink water, go drink water. Twenty minutes later, we will continue with the second operation. It is still a partial intestinal resection operation, which will be more difficult."
After Director Jia finished speaking, he went out first.
The physical fitness and functions of the elderly are much worse than those of the young.
There is still a tough battle to fight, so he must go to the bathroom quickly and replenish his water.
"Junior Brother Zhou, I never realized you are so amazing!"
Qiuhong smiled and took the initiative to talk to Zhou Can.
During the operation just now, the abilities Zhou Can displayed really shocked her.
"I'm sorry to have embarrassed you, Senior Sister. I'm just a mediocre person with a lot of flaws. Thanks to Director Jia for pointing them out to me, I feel like I've gained a lot ."
If Zhou Can admitted that he was capable, then his emotional intelligence would be extremely low.
The first step to making others feel like a spring breeze is to be humble.
"Haha, you only have some minor shortcomings. I can't even get started. Anastomosis is so difficult to practice. How do you practice it? Can you teach me someday?"
When Qiuhong smiles, her eyebrows and eyes are curved like a crescent moon.
Especially charming.
Her purpose of taking the initiative to talk to Zhou Can was to ask him how to practice anastomosis.
The two residents instinctively slowed down their pace and pricked up their ears to eavesdrop.
To be honest, they also really wanted to learn Zhou Can's anastomosis practice method because Zhou Can's anastomosis level was quite impressive.
Speaking of hard work, everyone has been working hard to practice surgery in private.
The money spent on buying mice to practice vascular anastomosis can take up a large part of their salary.
The price of mice used in medical experiments is relatively expensive, and the better ones basically cost more than 200 yuan. They are completely different from the pet mice sold in the market.
The mice used in medical research are all bred strictly in laboratories.
There are multiple inspection standards.
The mice in the market cost a few yuan each. Apart from other things, the bacteria and viruses they carry are terrifying.
"The training method may not be much different from your usual training. I usually anastomose the tail blood vessels and intestines of mice more. As for other training methods, there really are none."
Zhou Can now buys fewer mice.
Because he no longer gains much experience points from practicing with mice, it is not worth the time and money.
At my current level, practicing on patients is the fastest way to earn experience points.
He used to buy mice in batches of ten.
It costs two thousand dollars each time.
The cost of the cage is extra.
"mean!"
Qiu Hong didn't believe at all that he could improve so quickly just by practicing with mice.
"I'm not lying to you."
Zhou Can was speechless.
He would never tell anyone else about the medical experience system.
That was his core secret.
"I don't care. Whenever I come to you for advice, you have to teach me. You are my junior fellow apprentice!"
She used the ultimate privilege of a beauty to act coquettishly and cutely.
Zhou Can had to agree even if he didn't want to.
Looking at Dr. Qiuhong, who has always been quite aloof, being coquettish towards Zhou Can, the new intern, she even brought up the relationship between senior sister and junior brother.
The other male doctors were envious.
Many men dream of this kind of thing.
Zhou Can didn't feel much.
Because his girlfriend is younger and prettier than Qiuhong, and more importantly, the two of them already have a deep emotional foundation.
The upper part of a man's body is cultivation, and the lower part is instinct.
I have to add one more thing: a man who can control his inner desires is a real man.
Pink tent, hero’s tomb.
How many heroes have been defeated by the love of beautiful women.
Especially since China has experienced thousands of years of feudal society, almost all great writers have a hobby, which is romanticism.
This had a profound impact on later generations.
To this day, men still yearn for the life of a landlord with many wives and concubines.
…
Twenty minutes later, Zhou Can and other doctors returned to the operating room one after another.
The patient was put on the operating table.
This is a patient with colon cancer, who was diagnosed after a colonoscopy biopsy.
After taking the X-ray, Director Jia believed that there was still a chance for surgery.
The patient was not particularly old, only 38 years old. She had two children, the older one was only nine years old, and the younger one was only six years old. So she was very reluctant to leave this world.
I want to grow up with my children.
I don’t want my child to lose his mother at a very young age.
"Director Jia, doctors, and nurses, I'm counting on you!"
The female patient's eyes revealed a desire for life.
From her conversation and the way she calmly faced the illness, we can tell that this is a female patient with extremely high moral character.
If it were an ordinary female patient, being naked and covered with only a piece of cloth would be enough to make them feel embarrassed and they would not dare to look at people.
It is remarkable that she was able to overcome her inner embarrassment, face it calmly, and politely ask the medical staff to treat her.
In fact, in the eyes of doctors, there is really no distinction between men and women.
During the operation, everyone is thinking about how to perform the operation well for the patient. The whole process is full of risks and everyone is nervous. How can they care whether the patient is a man or a woman?
The anesthesiologist for this operation was still Dr. Guan.
Zhou Can didn't even need his instructions and took the initiative to come forward to help.
As for the other doctors, they chose to watch from the sidelines.
They also know how to place tubes.
However, no one is as proficient as Zhou Can in operating and connecting various instruments and adjusting ventilator parameters.
There are even many doctors who, even if they have reached the level of attending physicians, still only know how to use a ventilator.
They simply don't know how to flexibly adjust specific parameters.
This is because their training time in the Department of Critical Care Medicine is very short, and what they can learn is very limited.
But it doesn’t matter. As long as they perform well in the future, they can get the opportunity to study in the Department of Critical Care Medicine.
You can make up for the knowledge you haven't learned.
The patient was successfully equipped with a breathing mask and the probe of the life monitoring device, and the necessary tube placement and access construction were completed, and then general anesthesia was implemented.
While the patient was undergoing general anesthesia, Zhou Can had already begun to carefully review the patient's examination report.
He has come into contact with many cancer patients and has seen various types of cancer.
Colon cancer is a relatively common cancer.
This disease is more likely to occur especially for those who have irregular diet, unhealthy diet and lack of exercise.
As a preventive measure, in addition to healthy eating and more exercise, regular colonoscopy is very necessary.
Especially if a direct relative or family member is diagnosed with similar cancer, you should be more vigilant.
While doing his residency in cardiothoracic surgery, Zhou Can saw a family of five brothers and sisters, three of whom had liver cancer.
Many times, cancer is like rats, and they tend to gather in groups and form nests.
For example, some families love to eat bacon and fried foods. If everyone lives together, they will definitely eat more of them. If one person gets cancer, the risk for others will increase significantly.
There is also the issue of genetic inheritance.
This remains unsolved to this day.
"Who will open the abdomen?"
Director Jia asked.
"I'll do it!"
“I, I!”
This time it was interesting, whether it was the deputy chief physician who had always been proud of his status, or several attending physicians, they all rushed to do the job.
On the contrary, Zhou Can did not get the chance to open the abdomen.
For him, opening the abdomen was nothing more than gaining a few points of experience in cutting.
If you want to become a big tree, don't compete with grass.
When it is time to give up some small interests, you must give them up decisively.
He is now targeting more difficult intestinal segment separation, resection, anastomosis, or other newly added high-difficulty surgical tasks.
Open the abdomen and close the cavity, and leave it to these people to fight for.
The first time I competed with them, my main goal was to show my strength in every possible way and gain Director Jia's trust and recognition.
Now that this goal has been achieved, he will naturally stop robbing.
